Peix J L, Van Box Som P, Claeys K, Lapras V
Service de Chirurgie, Hôpital de l'Antiquaille, Lyon.
Presse Med. 1996 Mar 23;25(10):494-6.
Neck exploration is usually required in all cases of primary hyperparathyroidism. Without a precise localization preoperatively cervicotomy may be unsuccessful, especially in case of an ectopic adenoma.
A patient with primary hyperparathyroidism due to a solitary adenoma localized in the middle mediastinum was identified on preoperative computed tomography and technetium-99m-sestamibi radionuclide scan. The tumor was successfully removed at thoracoscopy without neck exploration.
Preoperative localization of primary hyperparathyroid tumors is not indicated in all patients. In some selected cases (acute hypercalcemia, reoperation, serious illness) prior neck exploration would be useful in guiding the surgeon.
所有原发性甲状旁腺功能亢进病例通常都需要进行颈部探查。若术前未精确定位，颈部切开术可能会失败，尤其是对于异位腺瘤的情况。
一名因位于中纵隔的孤立性腺瘤导致原发性甲状旁腺功能亢进的患者，在术前计算机断层扫描和锝-99m-甲氧基异丁基异腈放射性核素扫描中被发现。该肿瘤在胸腔镜检查下成功切除，未进行颈部探查。
并非所有原发性甲状旁腺肿瘤患者都需要术前定位。在一些特定病例（急性高钙血症、再次手术、重病）中，先前的颈部探查对指导外科医生会有帮助。
